The MOTS (Medication Overuse Treatment Strategy) Trial

NCT ID: NCT02764320

Last Updated: 2021-11-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

720 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-09

Study Completion Date

2021-03-31

Brief Summary

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There are two commonly used treatment strategies for treating patients who have chronic migraine with medication overuse. This study will compare the outcomes amongst patients randomized to one of the two treatment strategies.

Detailed Description

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Conditions

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Migraine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Discontinuation

Migraine prophylactic therapy will be initiated or optimized with the immediate discontinuation of the overused medication(s)

Group Type ACTIVE_COMPARATOR

Discontinuation of Overused Medication

Intervention Type OTHER

Immediate discontinuation of the overused medication(s) and the start of new migraine preventive therapy or adjustment of current preventive therapy

Preventive Therapy Only

Migraine prophylactic therapy will be initiated or optimized without the early discontinuation of the overused medication(s)

Group Type ACTIVE_COMPARATOR

Migraine Prophylactic Therapy Only

Intervention Type OTHER

Start of new migraine preventive therapy or adjustment of current preventive therapy without immediate discontinuation of the overused medication(s)

Interventions

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Migraine Prophylactic Therapy Only

Start of new migraine preventive therapy or adjustment of current preventive therapy without immediate discontinuation of the overused medication(s)

Intervention Type OTHER

Discontinuation of Overused Medication

Immediate discontinuation of the overused medication(s) and the start of new migraine preventive therapy or adjustment of current preventive therapy

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults, at least 21 years of age
* Chronic Migraine - diagnosed according to ICHD3beta criteria
* Medication Overuse - diagnosed according to ICHD3beta criteria
* Willingness to be randomized to either of the two treatment arms
* Willingness to maintain a headache diary
* Plan for follow-up care with the clinician
* No changes to migraine prophylactic therapy within the 4 weeks prior to randomization.

Exclusion Criteria

* Younger than 21 years of age
* Headache diagnoses other than chronic migraine with medication overuse; episodic tension-type headache on 3 or fewer days per month is allowed
* Not willing to be randomized to either of the treatment arms
* Not willing to maintain a daily headache diary
* Not planning on follow-up care with the clinician
* In the opinion of the clinician, randomization to either treatment arm would be considered unsafe (ex: pregnancy, immediate discontinuation
* Prisoners
* Diminished decision-making capacity which in the investigator's opinion would interfere with the person's ability to provide informed consent and complete study procedures.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Todd J. Schwedt

PI

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Todd J Schwedt, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

David W Dodick, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Northern Arizona Healthcare Medical Group

Flagstaff, Arizona, United States

Site Status

Mayo Clinic in Arizona Headache Center

Phoenix, Arizona, United States

Site Status

Mayo Clinic in Arizona Neurology Center

Phoenix, Arizona, United States

Site Status

Honor Health Neurology

Scottsdale, Arizona, United States

Site Status

Mayo Clinic Thunderbird

Scottsdale, Arizona, United States

Site Status

Keck Medical Center of USC

Los Angeles, California, United States

Site Status

University of Colorado Denver Headache Center

Aurora, Colorado, United States

Site Status

University of Colorado Denver Primary Center

Denver, Colorado, United States

Site Status

Blue Sky Neurology

Greenwood Village, Colorado, United States

Site Status

Memorial Healthcare

Hollywood, Florida, United States

Site Status

University of Miami Miller School of Medicine

Miami, Florida, United States

Site Status

Norton Neurology

Louisville, Kentucky, United States

Site Status

Brigham Women's Hospital Headache Clinic

Boston, Massachusetts, United States

Site Status

Brigham Women's Hospital Neurology Clinic

Boston, Massachusetts, United States

Site Status

Henry Ford Allegiance Health

Jackson, Michigan, United States

Site Status

Mayo Clinic Headache Center

Rochester, Minnesota, United States

Site Status

The Headache Center

Ridgeland, Mississippi, United States

Site Status

Clinvest Research

Springfield, Missouri, United States

Site Status

University of Cincinnati Neurology

Cincinnati, Ohio, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

University of Cincinnati Headache Center

Dayton, Ohio, United States

Site Status

Toledo Clinic Adult Neurology

Toledo, Ohio, United States

Site Status

Thomas Jefferson University Hospital Headache Center

Philadelphia, Pennsylvania, United States

Site Status

Preferred Headache Center

Pittsburgh, Pennsylvania, United States

Site Status

University of Utah Primary Care

Salt Lake City, Utah, United States

Site Status

University of Utah General Neurology

Salt Lake City, Utah, United States

Site Status

University of Utah Headache Center

Salt Lake City, Utah, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

West Virginia University Neurology

Morgantown, West Virginia, United States

Site Status

Countries

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United States

References

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Whitaker DJ, Dumkrieger GM, Hentz JG, Dodick DW, Schwedt TJ. Physical impairment during and between migraine attacks: A daily diary study of patients with chronic migraine. Cephalalgia. 2024 Apr;44(4):3331024241249747. doi: 10.1177/03331024241249747.

Reference Type DERIVED
PMID: 38663902 (View on PubMed)

Schwedt TJ, Hentz JG, Sahai-Srivastava S, Murinova N, Spare NM, Treppendahl C, Martin VT, Birlea M, Digre K, Watson D, Leonard M, Robert T, Dodick DW; MOTS Investigators. Patient-Centered Treatment of Chronic Migraine With Medication Overuse: A Prospective, Randomized, Pragmatic Clinical Trial. Neurology. 2022 Apr 5;98(14):e1409-e1421. doi: 10.1212/WNL.0000000000200117. Epub 2022 Feb 15.

Reference Type DERIVED
PMID: 35169011 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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Other Identifiers

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PCORI

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

16-001036

Identifier Type: -

Identifier Source: org_study_id